Individual
MELISSA WEST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
921 S VAL VISTA DR UNIT 26, MESA, AZ 85204-5610
(480) 299-7264
Mailing address
PO BOX 24718, TEMPE, AZ 85285-4718
(480) 299-7164
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
BH8805
AZ
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
BH8805
AZ
Other
Enumeration date
10/16/2023
Last updated
10/16/2023
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